decisionhealth Newsletters, Answer Books - 2009 Issue 9 (September)
Charges for Medicare Services / Non-participating physician charges
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Article Overview
This premium article discusses Medicare charge limitations for non-participating physicians, including the difference between assigned and unassigned services and the general concept of the limiting charge. It is useful for physicians, billing staff, and coders who need to understand Medicare payment participation status and the types of services subject to these charge rules.
Why This Topic Matters
Understanding these Medicare charge limits helps providers avoid billing errors and align patient charges with participation status and assignment rules.
What You Will Learn
- How Medicare charge limits differ for participating and non-participating physicians
- What assignment status means for physician services
- Which broad categories of services may be subject to limiting charge rules
- How Medicare payment participation relates to patient billing
Who Should Read This
- Physicians
- Medical billing staff
- Medical coders
- Practice administrators
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